This application simulates eye motion and
demonstrates the effects of disabling one or more of the 12 eye muscles and one
or more of the 6 cranial nerves that control eye motion. The purpose of this
simulator is to teach medical students and doctors how the eye motion will
change with pathology of the eye muscles and cranial nerves and what to look for
during a standard neurological eye exam.

You need the Macromedia Shockwave Plug-in in
order to see the eyes. You can download
Shockwave from
Macromedia.

System Description.
The neurological eye motion simulator was created by using a combination of
Macromedia Director movies, Shockwave, JavaScript language, HTML language, and
the World Wide Web.

Macromedia Director provides an efficient
method of simulating a patient's eyes following a doctor's finger. However,
instead of a finger, the eyes follow the mouse sprite. Based on a mathematical
model of eye motion, two eye images are moved behind a static image of a face.
The state of the eye muscles and associated cranial nerves are used to calculate
pathological eye motion.

Designed for World-Wide-Use.
Most graphical simulations for learning are limited to local use because either
they are not designed for the Internet. Most graphical simulators that are
designed for the Internet are also limited to users on T1 lines due to the high
bandwidth requirements. This neurological eye simulator not only is designed for
the Internet but has such a low bandwidth requirement that it can easily be used
by students at home through slow telephone modems.

Evaluation.
The eye simulator has been used for the past three years by students in the UC
Davis medical anatomy class. Professors also use it as a teaching aid during
lecture on a LCD projector.

The eye simulator is now being used worldwide
by medical students, as well as students of many other medically related
disciplines to help them learn eye muscle anatomy and neurological functions.
The eye simulator has been given a 5 star rating by the CAL Reviews of medical
education applications. (URL
http://cim.ucdavis.edu/users/rick/calreview.htm) The CAL Reviews is produced
by the Centre for Medical Interactive Technology as part of an IT initiative
with the Clinical Biomedical Computing Unit of the University of Cambridge
Clinical School (in England).

Although no formal statistical data has yet
been tabulated, feedback from medical students, residents, practicing
neurologists and ophthalmologists has been extremely positive and has indicated
that the simulator has been useful as an educational tool.

Conclusions.
The neurological eye simulator has successfully enhanced the inherent
limitations of the mechanical tennis ball model and has become a useful
educational application for medical students. Using the combination of Director,
Shockwave , and JavaScript provides a powerful simulator for educational. This
simulator also provides worldwide availability at a low bandwidth making it
usable by a large population of students and interested public.

This is only the beginning of our learning
simulation projects. Hewlett-Packard recently awarded the UC Davis Medical
School a $155,000 equipment grant to establish a virtual patient simulation
laboratory. Future development of the eye simulator will include enhancements to
simulate many common neurological conditions including strabismus, pathological
eye reflexes, etc. Future developments of the virtual patient simulator lab will
consist of realistic full body simulations to teach medical students basic
Internal Medicine cases.

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